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Original Articles
Rapid response system
Analysis of avoidable cardiopulmonary resuscitation incidents with a part-time rapid response system in place
Jun Yeun Cho, Dong Seon Lee, Yun Young Choi, Jong Sun Park, Young-Jae Cho, Ho Il Yoon, Jae Ho Lee, Choon-Taek Lee, Yeon Joo Lee
Acute Crit Care. 2021;36(2):109-117.   Published online April 16, 2021
DOI: https://doi.org/10.4266/acc.2020.01095
  • 5,259 View
  • 152 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract PDFSupplementary Material
Background
Although a rapid response system (RRS) can reduce the incidence of cardiopulmonary resuscitation (CPR) in general wards, avoidable CPR cases still occur. This study aimed to investigate the incidence and causes of avoidable CPR.
Methods
We retrospectively reviewed the medical records of all adult patients who received CPR between April 2013 and March 2016 (35 months) at a tertiary teaching hospital where a part-time RRS was introduced in October 2012. Four experts reviewed all of the CPR cases and determined whether each event was avoidable.
Results
A total of 192 CPR cases were identified, and the incidence of CPR was 0.190 per 1,000 patient admissions. Of these, 56 (29.2%) were considered potentially avoidable, with the most common cause being doctor error (n=32, 57.1%), followed by delayed do-not-resuscitate (DNR) placement (n=12, 21.4%) and procedural complications (n=5, 8.9%). The percentage of avoidable CPR was significantly lower in the RRS operating time group than in the RRS non-operating time group (20.7% vs. 35.5%; P=0.026). Among 44 avoidable CPR events (excluding cases related to DNR issues), the rapid response team intervened in only three cases (6.8%), and most of the avoidable CPR cases (65.9%) occurred during the non-operating time.
Conclusions
A significant number of avoidable CPR events occurred with a well-functioning, part-time RRS in place. However, RRS operation does appear to lower the occurrence of avoidable CPR. Thus, it is necessary to extend RRS operation time and modify RRS activation criteria. Moreover, policy and cultural changes are needed prior to implementing a full-time RRS.

Citations

Citations to this article as recorded by  
  • Changes in the incidence of cardiopulmonary resuscitation before and after implementation of the Life-Sustaining Treatment Decisions Act
    Hyunjae Im, Hyun Woo Choe, Seung-Young Oh, Ho Geol Ryu, Hannah Lee
    Acute and Critical Care.2022; 37(2): 237.     CrossRef
  • A Review of the Commercially Available ECG Detection and Transmission Systems—The Fuzzy Logic Approach in the Prevention of Sudden Cardiac Arrest
    Michał Lewandowski
    Micromachines.2021; 12(12): 1489.     CrossRef
Ethics
Transcultural Adaptation and Validation of Quality of Dying and Death Questionnaire in Medical Intensive Care Units in South Korea
Jun Yeun Cho, Jinwoo Lee, Sang-Min Lee, Ju-Hee Park, Junghyun Kim, Youlim Kim, Sang Hoon Lee, Jong Sun Park, Young-Jae Cho, Ho Il Yoon, Jae Ho Lee, Choon-Taek Lee, Yeon Joo Lee
Acute Crit Care. 2018;33(2):95-101.   Published online May 31, 2018
DOI: https://doi.org/10.4266/acc.2017.00612
  • 8,434 View
  • 159 Download
  • 9 Web of Science
  • 10 Crossref
AbstractAbstract PDFSupplementary Material
Background
Providing palliative care to dying patients in the intensive care unit (ICU) has recently received much attention. Evaluating the quality of dying and death (QODD) is important for appropriate comfort care in the ICU. This study aimed to validate the Korean version of the QODD questionnaire.
Methods
This study included decedents in the ICUs of three tertiary teaching hospitals and one secondary hospital from June 2016 to May 2017. ICU staff members were asked to complete the translated QODD questionnaire and the visual analogue scale (VAS) questionnaire within 48 hours of patient death. The validation process consisted of evaluating construct validity, internal consistency, and interrater reliability.
Results
We obtained 416 completed questionnaires describing 255 decedents. The QODD score was positively correlated with the 100-VAS score (Pearson correlation coefficient, 0.348; P<0.001). An evaluation of the internal consistency presented favorable results (calculated Cronbach’s alpha if a given item exceeded 0.8 in all items). The interrater reliability revealed no concordance between doctors and nurses.
Conclusions
The QODD questionnaire was successfully translated and validated in Korean medical ICUs. We hope further studies that use this valuable instrument will be conducted in Korea.

Citations

Citations to this article as recorded by  
  • Factors associated with the quality of dying and death and missed nursing care
    Shahin Gahramani, Mokhtar Mahmoudi, Nouri, Sina Valiee
    International Journal of Palliative Nursing.2024; 30(4): 190.     CrossRef
  • A systematic review of instruments measuring the quality of dying and death in Asian countries
    Shuo Xu, Yue Fang, Hanzhang Chen, Kang Sun, Chen Zhang, Yang Liu
    Quality of Life Research.2023; 32(7): 1831.     CrossRef
  • Translation, Validity and Internal Consistency of the Quality of Dying and Death Questionnaire for Brazilian families of patients that died from cancer: a cross-sectional and methodological study
    Bianca Sakamoto Ribeiro Paiva, Talita Caroline de Oliveira Valentino, Mirella Mingardi, Marco Antonio de Oliveira, Julia Onishi Franco, Michelle Couto Salerno, Helena Palocci, Tais Cruz de Melo, Carlos Eduardo Paiva
    Sao Paulo Medical Journal.2023;[Epub]     CrossRef
  • Russian nurses’ readiness for transcultural care of palliative patients
    Nataliya Kasimovskaya, Natalia Geraskina, Elena Fomina, Svetlana Ivleva, Maria Krivetskaya, Nina Ulianova, Marina Zhosan
    BMC Palliative Care.2023;[Epub]     CrossRef
  • Change in perception of the quality of death in the intensive care unit by healthcare workers associated with the implementation of the “well-dying law”
    Ye Jin Lee, Soyeon Ahn, Jun Yeun Cho, Tae Yun Park, Seo Young Yun, Junghyun Kim, Jee-Min Kim, Jinwoo Lee, Sang-Min Lee, Jong Sun Park, Young-Jae Cho, Ho Il Yoon, Jae Ho Lee, Choon-Taek Lee, Yeon Joo Lee
    Intensive Care Medicine.2022; 48(3): 281.     CrossRef
  • Factors Associated with Quality of Dying and Death in Korean Intensive Care Units: Perceptions of Nurses
    Haeyoung Lee, Seung-Hye Choi
    Healthcare.2021; 9(1): 40.     CrossRef
  • Validation of the Chinese Version of the Quality of Dying and Death Questionnaire for Family Members of ICU Patients
    Xing-ping Han, Xu Mei, Jing Zhang, Ting-ting Zhang, Ai-ni Yin, Fang Qiu, Meng-jie Liu
    Journal of Pain and Symptom Management.2021; 62(3): 599.     CrossRef
  • Validation of the Quality of Dying and Death Questionnaire among the Chinese populations
    Ying Wang, Mandong Liu, Wallace Chi Ho Chan, Jing Zhou, Iris Chi
    Palliative and Supportive Care.2021; 19(6): 694.     CrossRef
  • The quality of dying and death for patients in intensive care units: a single center pilot study
    Yanghwan Choi, Myoungrin Park, Da Hyun Kang, Jooseon Lee, Jae Young Moon, Heejoon Ahn
    Acute and Critical Care.2019; 34(3): 192.     CrossRef
  • Factors Associated With Quality of Death in Korean ICUs As Perceived by Medical Staff: A Multicenter Cross-Sectional Survey
    Jun Yeun Cho, Ju-Hee Park, Junghyun Kim, Jinwoo Lee, Jong Sun Park, Young-Jae Cho, Ho Il Yoon, Sang-Min Lee, Jae-Ho Lee, Choon-Taek Lee, Yeon Joo Lee
    Critical Care Medicine.2019; 47(9): 1208.     CrossRef
Case Report
Cardiology/Pulmonary
Successful Rescue Therapy with Pumpless Extracorporeal Carbon Dioxide Removal in a Patient with Persistent Air Leakage due to Empyema
Jaeyoung Cho, Yeon Joo Lee, Jae-Ho Lee, Choon-Taek Lee, Young-Jae Cho
Korean J Crit Care Med. 2017;32(3):284-290.   Published online November 14, 2016
DOI: https://doi.org/10.4266/kjccm.2016.00185
  • 8,603 View
  • 130 Download
AbstractAbstract PDF
A young metastatic lung cancer patient developed empyema due to an infection with carbapenem-resistant Acinetobacter baumannii. Hydropneumothorax was detected and managed by a tube thoracotomy. However, persistent air leakage through the chest tube was observed due to the presence of a bronchopleural fistula (BPF). As hypercapnic respiratory failure had progressed and the large air leak did not diminish by conservative management, a pumpless extracorporeal lung assist (pECLA) device was inserted. The pECLA allowed the patient to be weaned from mechanical ventilation and the BPF to heal. The present case shows the effective application of pECLA in a patient with empyema complicated with BPF and severe hypercapnic respiratory failure. pECLA enabled us to minimize airway pressure to aid in the closure of the BPF in the mechanically ventilated patient.
Original Article
Basic science and research
The Anti-Inflammatory Effect of Arginine-Vasopressin on Lipopolysaccharide-Induced IκBα/Nuclear Factor-κB Cascade
Jisoo Park, Eun Young Eo, Kyoung-Hee Lee, Jong Sun Park, Jae-Ho Lee, Chul-Gyu Yoo, Choon-Taek Lee, Young-Jae Cho
Korean J Crit Care Med. 2015;30(3):151-157.   Published online August 31, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.3.151
  • 6,558 View
  • 117 Download
  • 6 Crossref
AbstractAbstract PDFSupplementary Material
Background
Arginine vasopressin (AVP) is widely used as a vasopressor agent. Some recent studies have suggested that AVP may exert an immunomodulatory effect. However, the mechanism about the anti-inflammatory effect of AVP is not well known. We investigated the effect of AVP on the ihibitor of kappa B (IκBα)/nuclear factor-kappa B (NF-κB) pathway in RAW 264.7 cells.
Methods
Cultured RAW 264.7 cells were pretreated with AVP and stimulated with lipopolysaccharide (LPS). To evaluate the effect of AVP on inflammatory cytokines, the concentration of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were assessed by an enzyme-linked immunosorbent assay technique. The expression of IκBα and nuclear translocation of NF-κB p65 were measured by Western blotting, and IκB kinase (IKK) activity was analyzed by an in vitro immune complex kinase assay. To confirm the AVP effect on IκBα/NF-κB cascade and via V2 receptor, we added tolvaptan (V2 receptor antagonist) after AVP pretreatment.
Results
The increase of IL-6 and TNF-α in LPS-stimulated RAW 264.7 cells was suppressed by a treatment with AVP. Pretreatment of AVP inhibited increasing of IKK activity and IκBα degradation induced by LPS in RAW 264.7 cells. Furthermore, LPS induced and NF-κB transcription was inhibited by AVP pretreatment. The observed changes in IKK activity, IκBα degradation and NF-κB transcription by AVP was abolished by tolvaptan treatment.
Conclusions
Our results suggest that AVP showed anti-inflammatory effect on LPS-induced IκBα/NF-κB cascade in mouse macrophages via V2 receptors.

Citations

Citations to this article as recorded by  
  • Validity of mental and physical stress models
    Erin Hendry, Brady McCallister, Dan J. Elman, Roy Freeman, David Borsook, Igor Elman
    Neuroscience & Biobehavioral Reviews.2024; 158: 105566.     CrossRef
  • Osmoregulatory neurons clockwork is altered during metabolic disorder induced by high energy diet in the Sand rat Psammomys obesus
    Hanane Touati, Saliha Ouali-Hassenaoui, Aicha Dekar-Madoui, Nadir Benhafri, Lydia Boumansour, Etienne Challet, Paul Pévet, Patrick Vuillez
    Biological Rhythm Research.2023; 54(2): 153.     CrossRef
  • Microbial and Host Metabolites at the Backstage of Fever: Current Knowledge about the Co-Ordinate Action of Receptors and Molecules Underlying Pathophysiology and Clinical Implications
    Luigi Santacroce, Marica Colella, Ioannis Alexandros Charitos, Marina Di Domenico, Raffaele Palmirotta, Emilio Jirillo
    Metabolites.2023; 13(3): 461.     CrossRef
  • Birth triggers an inflammatory response in the neonatal periphery and brain
    Alexandra Castillo-Ruiz, Carla D. Cisternas, Hannah Sturgeon, Nancy G. Forger
    Brain, Behavior, and Immunity.2022; 104: 122.     CrossRef
  • Comprehensive biology of antipyretic pathways
    Prajitha N, Athira SS, Mohanan PV
    Cytokine.2019; 116: 120.     CrossRef
  • Oxytocin and Vasopressin Systems in Obesity and Metabolic Health: Mechanisms and Perspectives
    Cherlyn Ding, Faidon Magkos
    Current Obesity Reports.2019; 8(3): 301.     CrossRef

ACC : Acute and Critical Care